# TLC SUTTER HOME

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1487892253
- **Authorized official:** MRS. LISA KRISTINE SUTTER (ADMINISTRATER)
- **Authorized official phone:** (573) 769-2640

## Contact information

- **Practice address:** 209 LOGAN ST, PALMYRA, MO 63461-1336
- **Practice address phone:** (573) 769-7380
- **Mailing address:** 5051 HIGHWAY C, PALMYRA, MO 63461-2902
- **Mailing address phone:** (573) 769-2640

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 320600000X | Intellectual and/or Developmental Disabilities Residential Treatment Facility | — | MO | Yes |

## Other

- **Enumeration date:** 01/31/2009
- **Last updated:** 01/31/2009